Recurrent severe hypotony after cataract surgery in an eye with previous trabeculectomy

This report describes a patient who developed severe recurrent hypotony after uneventful phacoemulsification and intraocular lens (IOL) implantation 4 years after trabeculectomy. Hypotony was first noticed 1 month postoperatively and treated successfully with topical steroids. However, it reappeared 2 months later and slowly subsided only with steroid and cycloplegic treatment. There was no anterior chamber shallowing, leakage, or signs of inflammation. The cause of hypotony in this patient remains unknown. One possible explanation is subclinical postoperative inflammation as a foreign-body reaction to the IOL.